Correlation of COVID-19 with Severity of Periodontitis-A Clinical and Biochemical Study

Background: Various conceptual hypotheses have been put forth to link association of COVID?19 with various chronic diseases such as periodontitis. Empirical evidence is still lacking to correlate the severity of COVID?19 with periodontal diseases. Objectives: This study was undertaken with an objective to correlate COVID severity in systemically healthy patients suffering from periodontal diseases. Materials and Methods: 44 systemically healthy patients of both genders with minimum of 20 teeth in their oral cavity in age range of 20 to 50 years suffering from periodontitis were recruited and categorised into four stages as per American Academy of Periodontology (AAP) 2017 classification for periodontitis. Serum C?reactive protein (CRP) levels and periodontal disease parameters of all the patients were measured. Because of COVID?19 and the nationwide lockdown, the dental practice was highly affected. With the help of self?designed online questionnaire information regarding COVID?19 infection and associated symptoms were recorded. Cases were categorized into five groups based on the World Health Organization clinical progression scale of COVID severity. Results: All the patients suffering from COVID disease in moderate and severe forms had increased probing pocket depth, clinical attachment level, and raised serum C?reactive protein levels as compared to patients who were uninfected or suffering from mild COVID disease and the results were statistically significant. Conclusion: Prioritisation and Implementation of periodontal treatment as a preventive measure for COVID?19 should be done. A positive correlation is observed between the severity of periodontitis and COVID?19.

Efectos de la terapia periodontal no quirúrgica sobre el control glucémico de la Diabetes Mellitus Tipo 2: Revisión de literatura / Effects of non-surgical periodontal therapy on glycemic control of Type 2 Diabetes Mellitus: A literature review

Resumen Objetivo: Conocer la relación entre la enfermedad periodontal y la diabetes mellitus tipo 2, en el control de la glucemia. Diseño y métodos de investigación: Se realizó una búsqueda bibliográfica utilizando una base de datos (PubMed) con restricción del idioma inglés, buscando las investigaciones más recientes y con el mayor número de sujetos de investigación. Resultados: Los artículos revisados coinciden en que el tratamiento de la enfermedad periodontal mejora el control glucémico en pacientes con diabetes mellitus tipo 2, con una disminución promedio de 0,69% en el nivel de hemoglobina glucosilada (HbA1c). Conclusiones: El tratamiento periodontal mejora el control de la glucemia en pacientes con Diabetes Mellitus Tipo 2, debido a que disminuye el estado de inflamación sistémica y por lo tanto, también la cantidad de células inflamatorias (como IL6 y TNF- α) que provocan alteraciones en la actividad de la insulina.

Abstract Objective: To know the relationship between periodontal disease and type 2 diabetes mellitus in the control of blood glucose. Design and research methods: A bibliographic search was conducted using a database (PubMed) with english language restriction, looking for the most recent research and with the largest number of research subjects. Results: The articles reviewed coincide in the treatment of periodontal disease improves glycemic control in patients with diabetes mellitus type 2, with an average of 0.69% in the level of glycosylated hemoglobin (HbA1c). Conclusions: Periodontal treatment improves glycemic control in patients with Type 2 Diabetes Mellitus, as well as the number of inflammatory cells (such as IL6 and TNF-α) that cause alterations in insulin activity.

Doença de Alzheimer como fator de risco à doença periodontal: uma revisão de literatura / Alzheimer's disease as a risk factor to periodontal disease: a literature review

Introdução: A medicina periodontal é a área da periodontia que investiga a interação fisiológica e patológica entre a saúde do periodonto e/ou a Doença Periodontal na saúde sistêmica do individuo. Atualmente estudos evidenciaram possíveis correlações entre a Doença Periodontal e o Alzheimer, nestes trabalhos os autores consideram que estas patologias dividem fatores de risco e/ou modificadores em comum podendo haver uma relação bidirecional entres estas. Objetivo: Realizar uma revisão da literatura para descrever uma correlação entre o Alzheimer e a doença periodontal através dos fatores pro-inflamatórios, imunológicos e periodontopatogênicos. Materiais e Métodos: Foi realizada uma busca na literatura nas bases de dados: Google Acadêmico, PubMed, EBSCO e Scielo, contendo artigos científicos de 2000 até 2019, nos idiomas inglês e português usando os termos de pesquisa e descritores: "Periodontite Crônica" E/OU "Doença de Alzheimer" E/OU "Microbiologia periodontal" E/OU "Citocinas", como critérios de inclusão tivemos estudos de caso-controle, case series e estudos clínicos com criteriosa metodologia, aspectos metodológicos bem organizados estruturalmente e protocolos de pesquisa bem delineados. Conclusão: Consideramos que periodontistas e cirurgiões-dentistas devem estar atentos as possíveis associações entre o Alzheimer e a doença periodontal e durante os atendimentos estar atento aos sinais e sintomas do Alzheimer e orientar a pacientes, familiares e cuidadores quanto a correta higienização bucal, prevenção e tratamento da doença periodontal. (AU)

Introduction: Periodontal medicine is the area of periodontics that investigates the physiological and pathological interaction between periodontal health and / or periodontal disease in the individual's systemic health. Currently, studies have shown possible correlations between Periodontal Disease and Alzheimer's, in these studies, the authors consider that these pathologies divide risk factors and / or modifiers in common, and there may be a bidirectional relationship between them. Objective: To perform a literature review to describe a correlation between Alzheimer's disease and periodontal disease through pro-inflammatory, immunological and periodontopathogenic factors. Materials and Methods: A literature search was performed in the databases: Google Scholar, PubMed, EBSCO and Scielo, containing scientific articles from 2000 to 2019, in the English and Portuguese languages using the search terms and descriptors: "Chronic Periodontitis" E / OR "Alzheimer's Disease" AND / or "Periodontal Microbiology" AND / or "Cytokines", as inclusion criteria we had case-control studies, case series and clinical studies with methodological criteria, well structured methodological aspects and research protocols well outlined. Conclusion: We believe that periodontists and dental surgeons should be aware of the possible associations between Alzheimer's disease and periodontal disease, and during the visits to be alert to the signs and symptoms of Alzheimer's disease and to guide patients, family members and caregivers about correct oral hygiene, prevention and treatment of periodontal disease (AU)

Relación entre enfermedades periodontales y salud sistémica en la vejez / The relationship between periodontal disease and systemic health in the elderly

Se denomina Medicina Periodontal a la rama de la Odontología que busca las posibles asociaciones entre las enfermedades periodontales y enfermedades sistémicas, y su plausibilidad biológica. Esta relación se puede explicar por el paso directo de bacterias y/o mediadores inflamatorios a la sangre desde el tejido periodontal, pudiendo acceder y colonizar sitios específicos lejanos en el cuerpo, o por la propagación transtraqueal de patógenos periodontales. Si bien en la actualidad se han estudiado hasta 57 condiciones sistémicas relacionadas con las enfermedades orales y periodontales, se ha podido identificar asociaciones con Osteoporosis, Diabetes Mellitus, Enfermedad Pulmonar Obstructiva Crónica, Neumonía, Parto Prematuro y Bajo Peso al Nacer, Enfermedades Cardiovasculares, Artritis Reumatoide, Obesidad, Alteraciones Cognitivas, Cáncer, Síndrome Metabólico, Enfermedades Neurodegenerativas, Enfermedad Renal Crónica, entre otras. La presente revisión busca dar a conocer evidencia respecto a la relación entre Periodontitis Crónica y condiciones sistémicas prevalentes en los Adultos y Adultas Mayores

The branch of dentistry enquiring into possible associations between periodontal disease and systemic illness and their plausibility is Periodontal Medicine. This relationship may be explained by the direct passage of bacteria and/or inflammatory mediators from periodontal tissue to the blood, thus reaching and colonising distant sites in the body, or the transtracheal propagation of periodontal pathogens. 57 systemic conditions related to oral and periodontal disease have been studied and associations with osteoporosis, diabetes mellitus, COPD, pneumonia, prematurity and low birth weight, cardiovascular disease, rheumatoid arthritis, obesity, cognitive alterations, cancer, metabolic syndrome, neurodegenerative diseases and chronic kidney disease, amongst others have been identified. This review aims to bring to light evidence relating to the relationship between chronic periodontitis and systemic conditions prevalent in adults and the elderly.

Estudio preliminar del estado periodontal de pacientes con infarto cerebral isquémico / Preliminary study of the periodontal status of patients with ischemic stroke

Introducción: se reporta a la periodontitis como factor de riesgo de las siguientes enfermedades: diabetes mellitus, partos pretérminos, neonatos bajo peso, infecciones respiratorias, entre otras. Se atribuye destacada importancia al vínculo con enfermedades derivadas de la ateroesclerosis como infartos cardíacos y cerebrales. Objetivo: determinar posible asociación entre enfermedad periodontal e infarto cerebral isquémico aterotrobótico. Materiales y métodos: entre octubre 2015 y marzo del 2016, se realizó un estudio transversal observacional, de casos y controles, en los Hospitales "Freyre de Andrade" y "Dr. Luis Díaz Soto". Se registraron factores de riesgo para el infarto cerebral isquémico aterotrobótico y el estado periodontal, según el indice periodontal de Russell. El grupo control se homologó respecto a los casos en una proporción de 1X1, según edad, sexo, color de la piel y al menos 1 factor de riesgo reconocido del infarto cerebral. Se respetaron principios y normativas bioéticas para investigaciones biomédicas. Se emplearon medidas de resumen para datos cualitativos (frecuencias absolutas y porcentajes). Resultados: fueron estudiados 44 pacientes, 22 casos y 22 controles, mayoritariamente de 71 o más años, masculinos y blancos. Predominaron los pacientes con enfermedad periodontal sobre los sanos periodontalmente, 88,6 % y 11,4 %; respectivamente. La periodontitis fue el estado que prevaleció. La hipertensión arterial fue el factor asociado al infarto cerebral isquémico aterotrobótico que se presentó con mayor frecuencia, 61,4 %. Conclusiones: en todos los grupos la enfermedad periodontal predominó respecto al resto de factores de riesgo explorados del infarto cerebral isquémico, lo que pudiera sugerir asociación entre ambas enfermedades (AU).

Introduction: periodontitis is reported as a risk factor for diseases such as diabetes mellitus, preterm births, low weight neonates, and respiratory infections among others. The relationship between periodontal disease and diseases caused by atherosclerosis such as ischemic stroke and myocardial infarction has been emphasized. Objective: to determine the possible association between periodontal disease and atherothrombotic ischemic cerebral infarction (AICI). Materials and Methods: in the period from October 2015 to March 2016, an observational, case-control, cross-sectional study was carried out at the Hospitals "Freyre de Andrade" and " Dr. Luis Díaz Soto". Risk factors were recorded for AICI and the periodontal state, according to the revised Periodontal Russell's Index. The control group was homologated for cases at a ratio of 1x1, based on age, sex, skin color and at least 1 recognized AICI risk factor. Bioethical principles and regulations for biomedical research were respected. Summary measures were used for qualitative data (absolute frequencies and percentages). Results: 44 patients were studied, 22 cases and 22 controls, most of them aged 71 or more years, male and white. Patients with periodontal disease predominated over the periodontally healthy ones (88, 6 % y 11, 4 % respectively). Periodontitis was the most prevalent condition. High blood pressure was the most frequent factor associated to AICI, 61.4 %. Conclusions: in all groups, periodontal disease prevailed over the rest of the explored AICI risk factors, what may suggest an association between both diseases (AU).

Estado periodontal de pacientes con factores de riesgo aterotrombóticos y algunas enfermedades consecuentes / Periodontal status of patients with atherothrombotic risk factors and some subsequent diseases

Introducción: la periodontitis y la infección subgingival anaerobia asociada representan injuria metastásica que disemina mediadores inflamatorios favorecedores de la ateroesclerosis. La alta tasa de mortalidad por enfermedades cardíacas y cerebrovasculares en Cuba demanda estudios sobre factores de riesgo emergentes, para dirigir esfuerzos a su prevención y control. Objetivo: caracterizar la asociación entre enfermedad periodontal inmunoinflamatoria crónica (EPIC) y un grupo de enfermedades derivadas de la aterosclerosis. Materiales y Métodos: entre enero y marzo del 2017 se realizó un estudio transversal descriptivo, de casos y controles, en el consultorio No 13 del Policlínico "19 de Abril", municipio Plaza de la Revolución. Se conformó el grupo de casos con pacientes que padecieron enfermedades seleccionadas derivadas de la ateroesclerosis; el grupo de controles con sujetos que no las habían presentado. Se homologaron según edad, sexo y color de la piel. Se exploraron factores de riesgo ateroescleróticos y prevalencia y severidad de la EPIC según el Índice Periodontal Revisado. Se respetaron normativas bioéticas para investigaciones biomédicas. Se emplearon medidas de resumen para datos cualitativos y la prueba de independencia de chi-cuadrado (x2) para variables cualitativas. Resultados: existió igual cantidad de hombres que de mujeres, mayoritariamente blancos, entre 61 y 70 años. Las complicaciones ateroescleróticas más frecuentes fueron la angina de pecho y el infarto del miocardio. El factor de riesgo más común fue la hipertensión arterial. Solo hubo 3 pacientes sanos según la Periodoncia. Conclusiones: la asociación entre la EPIC y el grupo de enfermedades estudiadas derivadas de la aterosclerosis no fue estadísticamente significativa (AU).

Introduction: Periodontitis and its associated anaerobic subgingival infection represent metastatic injury that disseminates inflammatory mediators, which favor atherosclerosis. The high mortality rate for heart and cerebrovascular diseases in Cuba requires studies on emerging risk factors to direct efforts to their control and prevention. Objective: To characterize the association between chronic immune inflammatory periodontal disease (CIIPD) and some entities derived from atherothrombotic disease. Materials and Methods: Between January and March 2017, a cross - sectional descriptive study of cases and controls was carried out in the Medical Office # 13 of the Policlinic "19 de Abril", municipality of Plaza de la Revolución. The cases group was formed with patients who have suffered the chosen diseases derived from arteriosclerosis. The control group was formed by 1 X 1 mating, with subjects who had not presented diseases derived from atherosclerosis. They were validated according to age, sex and skin color. Atherosclerotic risk factors were explored, and also the prevalence and severity of CIIPD according to the Revised Periodontal Index. Bioethical principles and regulations for biomedical research were fulfilled. Summary measures were used for qualitative data and independent chi square test (X2) for qualitative variables. Results: The amount of men and women was the same, mostly white persons, aged 61-70 years. The most frequent atherosclerotic complications were angina pectoris and myocardial infarction. The most common risk factor was hypertension. From the point of view of Periodontics, there were only 3 healthy patients. Conclusions: The association among CIIPD and the chosen diseases derived from arteriosclerosis was not statiscally significant (AU).

Doenças periodontais e hipertensão primária grave: estudo transversal com 170 pacientes / Periodontal diseases and primary severe hypertension: a cross-sectional study with 170 patients

Objetivo: fazer um levantamento epidemiológico da prevalência de doenças periodontais em pacientes hipertensos. Material e métodos: entre março de 2007 e março de 2009, pacientes do Instituto Nacional de Cardiologia tiveram seus registros médicos examinados. A avaliação periodontal foi realizada por um profissional previamente calibrado e incluiu os seguintes parâmetros: índice de placa, índice de sangramento, profundidade de bolsa, e nível de inserção clínica. O nível de doença periodontal foi classificado conforme os critérios da AAP (1999). Resultados: 170 pacientes hipertensos primários graves, resistentes ao tratamento anti-hipertensivo, foram examinados. A média de idade foi 54 anos (faixa de 39-78 anos). Destes, 14% possuíam diabetes. O número de dentes presentes foi igual a 16 (faixa de 0-30). O percentual de sítios com placa visível e sangramento a sondagem foi, em média, 60% e 43%, respectivamente. Todos os pacientes examinados apresentavam perda de inserção decorrente da progressão da periodontite. Com relação ao diagnóstico da condição periodontal, 91% dos pacientes apresentavam periodontite crônica avançada, 6% apresentavam periodontite leve/moderada e 3% eram desdentados totais. Conclusão: dentro das limitações do presente estudo, foi possível concluir que a amostra composta de indivíduos portadores de hipertensão arterial primaria resistente apresenta uma prevalência de doenças periodontais destrutivas (periodontite) muito mais alta do que as descritas na literatura para indivíduos normotensos ou sem doenças cardiovasculares. Tais achados contribuem para reforçar a hipótese da existência de uma associação entre doenças periodontais (periodontite) e hipertensão arterial.

Objective: to make an epidemiologic survey on the prevalence of periodontal diseases for hypertensive patients. Material and methods: between March 2007 and March 2009, patients from the National Institute of Cardiology ­ Brazil had their medical records screened. The periodontal evaluation was made by a calibrated professional and included the following parameters: plaque index (PI), bleeding index (BOP), pocket probing depth (PPD), and the clinical attachment level (CAL). The level of the disease was classifi ed according the AAP guidelines (1999). Results: 170 patients having primary, resistant severe hypertension were examined. The mean age was 54 years (39-78 years). From these, 14% presented a diabetic condition. The mean number of residual dentition was 16 (0-30). The percentage of sites with visible plaque and BOP was 60% and 43%, respectively. All patients presented loss of periodontal attachment due to the progression of periodontitis. Regarding the periodontal condition, 91% of patients had advanced chronic periodontitis, 6% mild/moderate periodontitis, and 3% were completely edentulous. Conclusion: within the limitations of this study, it can be concluded that the prevalence of destructive periodontal disease in this sample of primary resistant hypertensive patients is higher than what can be found in the literature patients with no cardiovascular diseases. Such fi ndings contribute to reinforce the hypothesis of an association between periodontal diseases (periodontitis) and arterial hypertension.

A Clinical Case Report of Hashimoto's Thyroiditis And Impact On Treatment of Chronic Periodontitis.

Periodontitis is a multifactorial disease with microbial dental plaque as the initiator of periodontal disease. However the manifestation and progression of the disease is influenced by a wide variety of determinants and factors. The strongest type of causal relationship is the association of systemic and periodontal disease. Hashimoto’s thyroiditis has also been considered as one of the causes of periodontal disease. This clinical case report highlights the impact of Hashimoto’s thyroiditis on the outcome of periodontal therapy.

Relationship between periodontitis and rheumatoid arthritis and the effect of non-surgical periodontal treatment

This study analyzed the association of periodontal disease (PD) and rheumatoid arthritis (RA). Seventy-five 35-60-year-old patients were assigned to 5 groups according to the presence (+) or not (-) of PD and RA and the treatment received (TR+) or not (TR-) for PD. Group 3 uses total prosthesis (TP). Clinical and laboratory evaluations were performed at baseline, 3 and 6 months of follow-up by probing pocket depth, bleeding on probing and plaque index for PD, HAQ, DAS28, SF-36 and laboratory: AAG, ESR, CRP for RA. Statistically significant differences for PD after 3 (p=0.0055) and after 6 months (p=0.0066) were obtained in Group 1 (RA+PD+TR+) and 2(RA+PD+TR-); significant reduction in the percent of BOP after 6 months (p=0.0128) and significant reduction in the percent of Pl after 3 (p=0.0128) and 6 months (p=0.0002) in Group 1. Statistically significant differences between Groups 1 and 3 (RA+TP) for DAS28 at baseline and after 3 months were observed, but not after 6 months. No other parameters for RA were significantly affected. The relationship between RA and PD disease activities is not clear, but the importance of periodontal treatment in the control of inflammation to avoid tooth extraction is evident.

Este estudo avaliou a influência da doença periodontal (DP) na artrite reumatóide (AR). 75 pacientes, 35-60 anos, divididos em 5 Grupos, considerando a situação sistêmica e periodontal foram analisados. Um Grupo usava prótese total (PT). Os parâmetros clínicos e laboratoriais analisados: inicial, 3 e 6 meses receberam tratamento estatístico. As correlações entre as reduções da profundidade de sondagem, placa microbiana e sangramento à sondagem com as de Alfa 1, PCR, VHS e exames de qualidade de vida (HAQ, DAS28, SF36) foram também analisadas. Comparando o Grupo 1 (AR+DP+TR+) e Grupo 2 (AR+DP+TR-), aqueles que receberam tratamento periodontal não-cirúrgico (TPNC) tiveram reduções estatisticamente significativas em relação a PS aos 3 meses (p=0,0055) e 6 meses (p=0,0066); as reduções da por cento SS foram estatisticamente significantes aos 6 meses (p=0,0128) e da por cento PM aos 3 (p=0,0128) e 6 meses (p=0,0002). O TPNC não apresentou correlação com a melhora dos exames laboratoriais, nem com os exames de qualidade de vida. Comparando o Grupo 1 com o Grupo 3 (AR+PT) houve diferença estatisticamente significante no DAS28 inicial e 3 meses. Não foi possível verificar uma correlação direta do TPNC na atividade da doença sistêmica, mas pode-se constatar a sua importância, evitando a extração múltipla dos dentes.

Medicina periodontal: uma revisão de literatura / Periodontal medicine: a literature review

Medicina Periodontal é um termo emergente na área da saúde que se ocupa com o estudo do relacionamento bidirecional entre patologias periodontais e certas condições sistemáticas. Esse trabalho tem por objetivo abordar a consolidação da medicina periodontal com um novo paradigma na odontologia e relacionar as principais condições sistemïïaticas que podem ser influenciadas pelas doenças periodontais.

Periodontal medicine is an emerging term in the health area and studies the bi-directional relationship between systemic conditions and the periodontal diseases. The objective of the present work is to do an abbreviation literature review approaching the consolidation of the periodontal medicine as a new paradigm in the dentistry and relating the main systemic conditions that can suffer influence for the periodontal diseases.

A presença de patógenos respiratórios no biofilme bucal de pacientes com pneumonia nosocomial / Presence of respiratory pathogens in the oral biofilm of patients with nosocomial pneumonia

JUSTIFICATIVA E OBJETIVOS: O paciente internado em unidade de terapia intensiva (UTI), geralmente apresenta higiene bucal insatisfatória, podendo a região orofaríngea ser colonizada por patógenos envolvidos em pneumonia nosocomial. O objetivo deste estudo foi investigar a presença de patógenos respiratórios na cavidade bucal em pacientes em UTI. MÉTODO: Foram incluídos neste estudo transversal, 30 pacientes residentes no município de Nova Friburgo no estado do Rio de Janeiro, com idade entre 18 e 82 anos e média ponderada de 53,53 anos, sendo 17 homens e 13 mulheres, internados na UTI geral, excetuando a unidade coronariana, do Hospital Municipal Raul Sertã, Nova Friburgo, com diagnóstico de pneumonia nosocomial (PN). Foi realizada cultura das amostras do aspirado traqueal para identificar os micro-organismos responsáveis pela PN. Em contrapartida amostras microbiológicas da placa dental supragengival, da língua e do tubo do umidificador, foram analisadas para avaliação da presença do agente etiológico da PN. RESULTADOS: As bactérias mais freqüentemente encontradas no aspirado traqueal dos pacientes foram S. pneumoniae 23,3 por cento (7), P. aeruginosa 20 por cento (6), S. aureus 13,3 por cento (4), Kleibsella pneumoniae 13,3 por cento (4), Candida albicans 6,6 por cento (2), Streptococcus a-hemolítico 6,6 por cento (2), Staphylococcus sp. 6,6 por cento (2), Acinetobacter calcoaceticus - baumanii complex (A. calcoaceticus) em 1 paciente (3,3 por cento do total de pacientes), Eschericia coli (E.coli) 3,3 por cento (1), Enterobacter cloacae (E. cloacae) 3,3 por cento (1). Nesses pacientes, 70 por cento destas bactérias foram encontradas no biofilme dental, 63,33 por cento em amostras da língua, 73,33 por cento nas amostras do tubo do respirador artificial e em 43,33 por cento em todos as áreas simultaneamente. Não foram observadas diferenças significativas nas proporções das amostras dos locais de coleta (p > 0,05). CONCLUSÕES: Os resultados...

BACKGROUND AND OBJECTIVES: Hospitalized patients receiving treatment at intensive care units (ICU) usually show poor oral hygiene, and may have the mouth and oropharingeal region colonized by pathogens involved in nosocomial pneumonia. The presence of these pathogens may increase the risk for respiratory diseases. The aim of this study was to investigate the presence of respiratory pathogens in the oral cavity of hospitalized patients at ICU. METHODS: Were included in the study 30 patients from Hospital Raul Sertã, Nova Friburgo, with the diagnostic of nosocomial pneumonia, and tracheal aspirate samples were cultured to identify the causing microorganisms. In addition, microbiological samples from supragingival dental plaque, tongue and respiratory tube were cultured for the presence of a panel of respiratory pathogens. RESULTS: The most frequently found bacteria in the tracheal aspirate were S. Pneumoniae 23.3 percent (7), P. aeruginosa 20 percent (6), S. aureus 13.3 percent (4), K. pneumoniae 13.3 percent (4), C. albicans 6.6 percent (2), a-hemolytic streptococcus 6.6 percent (2), Staphylococcus sp. 6.6 percent (2), A. calcoaceticus 3.3 percent (1), E. coli 3.3 percent (1) and E. cloacae 3.3 percent (1). 70 percent (21) of these microorganisms were found in the dental biofilm, 63.33 percent (19) in tongue samples; 73.33 percent (22) in the respiratory tube; and 43.33 percent (13) in all sampling sites simultaneously. No differences in proportions could be observed between the sampling sites (p > 0.05) CONCLUSIONS: The results of this study show that respiratory pathogens associated with nosocomial pneumonia are present in the oral biofilm of hospitalized patients in ICU, which may serve as a reservoir for these microorganisms.